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COVID-19 大流行中的毛霉菌病:印度一家三级医院的研究。

Mucormycosis in COVID-19 pandemic: study at tertiary hospital in India.

机构信息

Department of ENT, GMC Miraj (Maharashtra), Miraj, India.

Department of Radiology, GGMC and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India.

出版信息

Eur Arch Otorhinolaryngol. 2022 Jun;279(6):3201-3210. doi: 10.1007/s00405-022-07282-1. Epub 2022 Feb 5.

Abstract

AIM

During the second wave of COVID-19, cases of mucormycosis were increased suddenly over a period of 3 months in Maharashtra, India. An attempt was made to study the clinical profile and risk factors associated with mucormycosis.

MATERIALS AND METHODS

A retrospective descriptive study was carried out at a tertiary hospital during May 2021-July 2021. After obtaining informed written consent from the participants, various details of all participants, such as diabetes mellitus, use of steroids in COVID-19 treatment, use of immunosuppressant drugs, oxygen therapy, use of ventilators, complications that occurred during treatment, etc., were noted. All mucormycosis patients were treated with amphotericin B and aggressive surgical treatment.

RESULTS

In the present study, 74.7% of mucormycosis patients were male. 77.4% of mucormycosis patients were above 40 years of age. 6.7% of mucormycosis patients were partially vaccinated. Among risk factors, 86.6% had diabetes mellitus, 84% had COVID-19 infection, 44% had received steroids, and 54.7% had received oxygen. 80% of patients were present during and within 1 month of COVID-19 infection. 52% of patients were presented in stage III and 41.3% were presented in stage II. Despite aggressive surgical debridement along with amphotericin B, mortality was 25.33%. 5.3% of patients had brain abscesses, 8% of patients had cavernous sinus thrombosis, 4% of patients had facial nerve palsy and 1.3% of patients had meningitis.

CONCLUSION

Mucormycosis was predominantly seen in male above the age of 40 years COVID-19 infection and diabetes mellitus was common risk factor for mucormycosis.

摘要

目的

在印度马哈拉施特拉邦 COVID-19 的第二波疫情中,毛霉菌病的病例在 3 个月内突然增加。本研究试图研究毛霉菌病的临床特征和相关危险因素。

材料与方法

本研究为 2021 年 5 月至 7 月在一家三级医院进行的回顾性描述性研究。在获得参与者的书面知情同意后,记录了所有参与者的各种详细信息,如糖尿病、COVID-19 治疗中使用类固醇、使用免疫抑制剂药物、氧疗、使用呼吸机、治疗过程中发生的并发症等。所有毛霉菌病患者均接受两性霉素 B 和积极的手术治疗。

结果

在本研究中,74.7%的毛霉菌病患者为男性。77.4%的毛霉菌病患者年龄在 40 岁以上。6.7%的毛霉菌病患者部分接种了疫苗。在危险因素中,86.6%有糖尿病,84%有 COVID-19 感染,44%接受了类固醇治疗,54.7%接受了氧疗。80%的患者在 COVID-19 感染期间和感染后 1 个月内出现。52%的患者处于 III 期,41.3%的患者处于 II 期。尽管联合两性霉素 B 进行积极的手术清创,但死亡率仍为 25.33%。5.3%的患者有脑脓肿,8%的患者有海绵窦血栓形成,4%的患者有面神经瘫痪,1.3%的患者有脑膜炎。

结论

毛霉菌病主要发生在年龄在 40 岁以上的 COVID-19 感染男性和糖尿病患者中,糖尿病是毛霉菌病的常见危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b7/8817651/c0f63548c219/405_2022_7282_Fig1_HTML.jpg

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